著者

徳増 厚二 長沼 英明 橋本 晋一郎 伊藤 昭彦 和田 昌興 岡本 牧人 山根 雅昭

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.66, no.2, pp.64-72, 2007 (Released:2008-10-10)

参考文献数

17

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Hyperosmotic solution of isosorbide has been used for treatment of Meniere's disease since Kitahara et al., Larsen et al. and Nozawa et al.. In recent studies reported that ADH is acting to open water channels, AQP-2 at the endlymphatic membrane and may act worse for labyrinthine hydrops. It is important the serum concentration of isosorbide after administration because ADH should be released if the serum osmotic pressure is elevated by isosorbide above more than 2% of normal serum osmotic pressure. In this study the equation predicting isosrbide serum concentration after oral administration was proposed on the basis of the data by Wakiya's report. It was confirmed the serum osmotic pressure remains below the threshold level for increasing ADH secretion by the routine method of 30 ml/once, 3 times every day. However, the method of 30 ml/once, single or two times every day should be recommended when the serum osmotic pressure before the medication is above 289 mOsm/kg.

著者

長沼 英明 河原 克雅 徳増 厚二 和田 昌興 上条 貴裕 岡本 牧人

出版者

一般社団法人 日本聴覚医学会

雑誌

AUDIOLOGY JAPAN (ISSN:03038106)

巻号頁・発行日

vol.49, no.5, pp.599-600, 2006-09-05 (Released:2010-08-05)

著者

長沼 英明

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.72, no.4, pp.259-267, 2013-08-31 (Released:2013-10-01)

参考文献数

18

被引用文献数

1 1

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Wistar rats were intraperitoneally injected with 0.02 units/g of AVP (Pitressin; Arg-vasopressin. Daiichi-Sankyo, Japan) in all the experiments in this study. ABR thresholds gradually increased significantly up to 60 min after the injection. When dehydration load pretreatment for 24h was added, ABR thresholds rapidly increased significantly up to 10 min after the injection. However, the morphological endolymphatic hydrops in the cochlea was not detected under light microscopy. On the other hand, the enlargement of an area lacking intracellular organelles in the intermediate cells in the stria vascularis or a so called “vacuole” was detected under transmission electron microscopy after the AVP injection. When the dehydration load pretreatment for 24h was added, the vacuole area increased with AVP injection. However, when a V2R antagonist (OPC-31260, donated by Otsuka Pharmaceutical) was administered before AVP, vacuole formation was suppressed significantly. Conversely, vacuole formation was not suppressed when a V1aR antagonist (OPC-21268, donated by Otsuka Pharmaceutical) was administered before AVP injection. As a clinical application based on above mentioned basic studies, we conducted hydration therapy for Meniere's disease. In the hydration therapy, basically the patients drank 35 ml/kg/day of water daily in addition to the normal daily beverages and foods for 2 years. Medication of 21 g was given whenever a vertiginous spell or hearing loss or aural fullness reoccurred. The outcomes were determined according to the criteria of the AAO-HNS 1995 guidelines. In the hydration therapy group, the definitive spells were controlled in 93% of the patients. The hearing in the hydration therapy group was improved significantly in comparison with the conventional therapy group.

著者

長沼 英明 設楽 哲也 徳増 厚二 岡本 牧人 平山 方俊

出版者

日本耳科学会

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.1, no.5, pp.44-48, 1991-12-20 (Released:2011-06-17)

参考文献数

20

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Frequently encountered are cases of perforated ear drum, for whom there is no opportunity of myringoplasty or operation to repair the perforation, owing to work or school. A new method of myringoplasty by intrameatal approach without skin incision and using a homograft of temporal fascia in an outpatient should thus be made available. The results of such myringoplasty in 15 ear cases, ranging in age from 21 to 75 years are presented in the following. The advantages of this treatment are summarized as follows;1) The operation can be done in an outpatient clinic.2) The surgical procedure is restricted to only the intrameatal region since obtaining the patients own temporal fascia is not necessary.3) Local anesthesia of the drum is sufficient for the operation.4) The patient may drink, eat, and return to work or school immediately following after surgery.5) The operation can be conducted on patients having general complications since general anesthesia is not required.However, the success rate of closure of the perforation was 67 per cent in this study. The reasons why the transplanted fascia was not “self” so to speak are considered. Attempts are being made to improve this rate such as by treatment of a homograft and application of fibronectin extracted from the patient's own serum to promote adherence of the graft.

著者

伊保 清子 浅野 和江 村山 真弓 阿久津 二夫 長沼 英明 徳増 厚二 岡本 牧人

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.70, no.2, pp.67-76, 2011 (Released:2011-06-01)

参考文献数

13

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Appearance of the dominant peak-frequency in body sways during standing was retrospectively investigated in patients with spinocerebellar degeneration (SCD). Subjects tested were 25 patients with SCD (16 men and 9 women, ranging in age from 25 to 80; mean 55.8±15.4 yr). The disease types comprised SCA3 (n=5), SCA 6 (n=3), MSA-C (n=12), and an unknown type (n=5). Stabilometry was performed in each patient, who was asked to stand upright with a closed stance, with eyes open and eyes closed, using Anima's stabilometer G6100. The sampling time was 50 ms (20Hz) and the correcting time was 60 s. The peak-frequency was measured based on the power spectrum using the maximum entropy method (MEM). Total locus length, envelope area and velocity-vector of movement of the center of foot-pressure were also measured.The first or main peak appeared in a low frequency range between 0.10 and 0.59Hz in most of the cases with eyes open and eyes closed. It was detected in the lateral direction in 24 patients of the total number (96.0%) and in the anterior-posterior direction in 22 patients of the total (88.0%).The body sway of a frequency of 3Hz was detected in 4 patients (16.0%). Among them, the peak in the lateral direction was observed in 2 (8.0%) with eyes open or closed (one with SCA 6 and one with an unknown disease type). The peak in the anterior-posterior direction was detected in 3 (12.0%) with eyes open or closed (one each with SCA 6, MSA-C and an unknown disease type); in these subjects, the values of the total locus length divided by envelope area were more than 40.The dominant peak-frequency of 3Hz in body sways during standing did not frequently appear in patients with SCD, but it is suggested to be one of characteristic balance disorders in the disease.